Know Your Numbers

Most Americans don't understand health care. Here's what you need to do to make sure you're not one of them.

88% of Americans don’t understand basic health information. That’s the finding from an American Heart Association study released in June that shows most Americans don’t know what bad blood pressure numbers are, the causes of diabetes, and some didn’t understand the results of a basic health test. As a nation, our limited health literacy is preventing us from identifying the symptoms and warning signs of cardiovascular disease as well as the treatments and lifestyle steps needed to prevent it.

Dr. Jeffrey Uzzilia a board certified cardiologist at Capital Cardiology Associates has a special interest in coronary artery disease treatment and prevention, as well as congestive heart failure. As a specialist in heart health, he sees the confusion patients have with health information. “I can understand why people don’t have a great grasp on their blood pressure numbers,” says Uzzilia. “There has been a lot of confusion over the new blood pressure guidelines, the most recent numbers that were published last year were quite different from the guidelines that were published in the past five years. Five years ago the guidelines suggested that blood pressure could be less that 140 over 90. Within five years the new guidelines say that 120 over 80 would be the ideal number. I think it’s confusing for people.”

The scientific statement published in the American Heart Association’s journal Circulation reported that more than half of people with low health literacy did not recognize an abnormal blood pressure reading are less likely to get it under control. As Uzzilia asserts, “It’s our responsibility as medical providers to explain why there are differences, why the guidelines are important, but why there may be reasons why we disagree with the guidelines.” Why would a physician disagree with blood pressure guidelines? “The model from several years ago I disagreed with and I prefer the new numbers where they acknowledge that maybe the blood pressure is not as high but lowering it does have some benefits particularly in women who are at higher risk for stroke even with minor elevations in their blood pressure.”

The reason for changing the numbers

The goal of the change is to help people take steps to control their blood pressure earlier to reduce hypertension, a major risk factor for heart disease and stroke. Last year, the American Heart Association with the American College of Cardiology redefined high blood pressure for the first time in 14 years. “The new guidelines for normal or healthy blood pressure is 120 for the systolic and 80 for the diastolic,” reported Uzzilia. The new guidelines eliminate the category of prehypertension, which was used for blood pressures between 120-139 over 80-89. People with those readings now will be categorized as having either Elevated (120-129 and less than 80) or Stage I hypertension (130-139 or 80-89). As a result of these changes, half of the adult population (46% of US adults) will have high blood pressure, or hypertension. Most impacted are men and women under the age of 45 who will consulted by their doctor on healthy lifestyle changes.

Dangers of high blood pressure

The American Heart Association warns that high blood pressure accounts for the second largest number of preventable heart disease and stroke deaths, second only to smoking. It’s known as the “silent killer” because often there are no symptoms, despite its role in significantly increasing the risk for heart disease and stroke. High blood pressure is a common disease. You have a higher risk for this disease if you are overweight. Your risk is higher if you eat a diet high in salt, if you drink a lot of alcohol or if you don’t exercise enough. Your risk gets higher as you get older. This disease is more common in men and in African Americans. Plus, you have a higher risk if you have a family history of this disease.

It’s important that you have regular visits with your doctor and understand your blood pressure numbers so that your doctor can work with you on a plan to manage your condition. Treatment options often include a healthier lifestyle (free of smoking, alcohol, with more exercise, and a heart healthy diet) and medications. If left untreated, high blood pressure becomes severe and can lead to sever complications even heart attack, stroke, an aneurysm, kidney problems, and vision loss.

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Learn more about Heart Conditions like high blood pressure and hypertension as well as Heart Procedures performed by the board-certified physicians at Capital Cardiology Associates.

Heart Conditions

Heart Procedures

What your numbers mean and why they matter

Blood pressure is measured with two numbers written like a fraction. The top number is the pressure in your arteries when your heart is pushing out blood. The bottom number is the pressure between beats, when your heart is resting. The higher the pressure, the greater your risk for health problems. As Dr. Uzzilia discussed, that is where the confusion begins. “There’s a lot of misinformation about your blood pressure numbers. I’ve had patients tell me that, ‘all that matters is the lower number,’ or the diastolic pressure. Or that, ‘only the top,’ or the systolic number matters. In fact, they are both very important. The systolic number is the peak number or the high number when blood is ejected out in the arterial circulation from the heart. The diastolic blood pressure is the lower number after the heart has already pumped the residual pressure in between the heartbeats.”

Overall, knowing your numbers and having healthy blood pressure will lead to a lower risk of stroke, cardiovascular disease, and kidney failure. Know your numbers by seeing your doctor for a yearly visit. Also incorporate a heart-healthy diet that reduces salt and incorporates potassium-rich foods such as bananas, potatoes, avocados and dark leafy vegetables. If you are an adult over 40, ask your doctor for suggestions on weight loss, quitting cigarette smoking, cutting back on alcohol and increasing physical activity.

Written by: Michael Arce, Media Specialist

Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.

Stress and Heart Disease

Heart Disease, Heart Health

Stress and Heart Disease

Your job stress could increase your risk of heart disease

People who have high-stress jobs — such as fire fighters — may be more likely to develop A-fib.

A new Swedish study on work stress shows that individuals with high-strain jobs are more likely to develop atrial fibrillation (AFib). AFib is a common kind of irregular heartbeat that often rapid heart rate that commonly causes poor blood flow. It is quite common in the United States with more the 200,000 cases reported every year. At least 2.7 million Americans are living with AFib.

As the researchers from Stockholm University noted, “it has been observed that occupational exposures, such as noise, night work, long working hours and work-related psychosocial factors, including work stress, are associated with coronary heart disease and stroke. However, few studies have been undertaken to explore occupational exposures in relation to atrial fibrillation risk and, to our knowledge, only two studies have previously been published regarding work stress and atrial fibrillation.” Dr. Jeffrey Uzzilia, board-certified cardiologist at Capital Cardiology Associates, stated that the relationship between stress-related jobs and heart health extends to those who often work to protect our laws and lives. “As in this study, we find that heart disease is much more prevalent in service oriented jobs where you have to go from from 0 to 100 miles per hour, like fire fighters and police officers. That risk occurs not only when they are on the job but also after they retire.”

The Swedish study found the “biological pathway between work stress and the development of atrial fibrillation” connecting mental stress as the cause of elevated blood pressure, inflammation and hypertension, and abnormal electrical activity in the left atrial of the heart. Uzzilia concurred with the findings. “Stress plays a big role in the release of adrenaline and other hormones inside the body that can trigger arrhythmia, they can cause generalized inflammation that is associated with atherosclerosis: the process that leads to heart disease and blockages in the arteries.”

Stress and the workplace

It has been known for some time that stress affects each person’s heart health differently as everyone feels stress and reacts to it in different ways. Most people dislike the feeling of being “stressed out” that comes from our personal lives. In our private life we can limit our exposure, removing ourselves from stressful situations or limiting our interaction with people or places that induce stress. However, stress at work, unlike our personal life, can be difficult to escape or evade. “Stress, particularly the kind of stress where you have little control over but you have a lot demand on you to perform, that can overwhelm you emotionally and can trigger factors that increase heart disease,” added Uzzilia.

In 2012, 65 percent of Americans cited work as a top source of stress, according to the American Psychological Association‘s (APA) annual Stress in America Survey. Only 37 percent of Americans surveyed said they were doing an excellent or very good job managing stress. The challenge is: it’s not entirely possible to avoid stress at work. The best we can do is manage stress. For those with traditional desk jobs that includes becoming better organized, add comfort (think about desks, chairs, furnitures, playing music) when possible to our work area, walking on breaks, and chunking (taking individual pieces of information and grouping them together) instead of multitasking on projects.

For service oriented careers like fire fighters, police officers, emergency medical staff, you need to be aware of the signs of stress and take time to refocus and repair any damage. Simple steps like getting enough sleep, exercising, eating healthy, avoiding bad lifestyle choices, have a strong network of friends and family, and maintaining your sense of humor.

Talk with your doctor

As with all aspects of your health, if you feel overwhelmed by work stress talk with your doctor.

If you have a concern for your heart health, ask your doctor about a cardiac CT scan. About 15 years ago Capital Cardiology Associates offered local firefighters access to this procedure which provides high quality images of your heart muscle and vessels. As Dr. Lance Sullenberger, Co-Medical Director of the Cardiovascular CT Scanning Suite at Capital Cardiology Associates, explained, “with this technology we can see if there is plaque in the arteries. That plaque can then be scored using a software package that uses the number of pixels and density that gives us a score.”

Your calcium score is the best predictive model for your risk of having a heart attack, stroke, or dying from cardiovascular disease in the near future. Capital Cardiology Associates now offers free calcium scoring to the New York State Troopers as well as other area law enforcement officers due to the stress factors associated with their professions. For more information on calcium scoring and Cardiac CT Scanning please call us at 518-292-6030. Sullenberger notes, “when I look at calcium scoring, I usually start thinking about calcium scoring people in the mid 30’s, especially if they have a strong family history. Certainly people over 40. Above that age, I think everyone should at least consider or discuss with their physician if calcium scoring is appropriate for them.”

Written by: Michael Arce, Media Specialist

Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.

Enhanced Cardiac Access Suite at Capital Cardiology

Corporate Woods, Heart Health

Enhanced Cardiac Access

Providing immediate treatment to patients experiencing cardiac symptoms

Capital Cardiology Associates Enhanced Cardiac Access is available at our Albany and Clifton Park locations. On a recent episode of HeartTalk presented by Capital Cardiology Associates, I was joined by Dr. Jeffrey Uzzilia to discuss the significance of the ECA. “The ECA is one of the best things we have ever done at CCA,” announced Uzzilia. “Years ago we had been talking about ways to better connect with patients, more directly, and provide better access for cardiology care. We know that it’s frustrating for patients that feel like they have a problem and want to be seen, but then trying to navigate the medical system can be difficult.”

The “ECA”, as it’s referred to by staff, was officially launched in 2014. Uzzilia remembers its beginnings. “When we opened the ECA it was a relatively small unit in our office. And the idea was that we could treat some non-life threatening but more urgent matters in our office rather than having patients go to the emergency room or to the hospital.” That experience with patients proved to be very positive. “We initially anticipated that we would send approximately 10% of those patents to the hospital. The remainder we would be able to keep in the office without having to send them to the hospital at all. We learned over the past three to four years that we can deal with a lot of medical problems on an outpatient basis.”

Dr. Jeffrey Uzzilia

Doctor driven health care

For those experiencing a heart attack a trip to the emergency room can be almost as traumatic as the condition you are seeking treatment. In 2015 The National Center for Health Services, part of the CDC, reported almost 140 million emergency room visits that year. The data shows that only 35.4% of visits patents were seen in fewer than 15 minutes. Emergency rooms typically triage patients by the severity of their injury, illness, or medical condition. Patients with cardiac events, like heart attack or stroke, are usually given high priority. Even with this assurance, as a study from the University of Maryland School of Medicine Department of Emergency Medicine shows emergency rooms are flooded with patients who are without access to healthcare, health insurance, or preventative care. Overall an ER visit is an experience most of us would rather avoid if possible.

To overcome the challenge of streamlining procedures and testing to offer a better quality level of care, Uzzilia points out how the ECA empowers the cardiologist to direct and manage the schedule of patient testing and care. “One of the advantages that we, as cardiologists in the ECA, we control treatment. We have the tools to get these tests, we can order the right tests, we don’t have to order any additional testing because we have what we want available.” And just as with your local emergency room, the ECA provides immediate medical attention. “You do not need to be a Capital Cardiology Associates’ patient to use the ECA. You can self-refer. You don’t need an appointment. You can walk right into our office and tell our team your symptoms and the nurses will bring you back to start the evaluation process. Our ECA suite has three board certified cardiologists, advanced practitioners, and we have cardiac nurses and technicians who are ready to accept patients all throughout our workday.”

Capital Cardiology Associates Enhanced Cardiac Access suite serves about 500 patients a month. “One of the great examples that I have given to a physician who came to tour the ECA,” says Uzzilia, “was a patient with atrial fibrillation. Now in the past that patient would always go to the emergency room. They would be there for a couple of days under evaluation. A lot of times now we can take them in ECA and we can do their full evaluation, often on the first day. We can evaluate their thyroid with blood tests. We can look at the structure of their heart with an echocardiogram. We can start them on blood thinners so they are not at risk for a stroke. We can give them oral or intravenous medication right away to begin the process of slowing their heart down.”

Medical bills are also a detraction for people to seek treatment or avoid an emergency room visit. The Healthcare Bluebook quotes $762 to $2,929 or more for a emergency room visit for a severe problem. The cost of basic health care is a massive financial burden patients experience after an ER visit or hospital stay. The Patients’ Perspectives on Health Care survey conducted in 2016 indicated that health care costs cause serious financial problems for more than a quarter of Americans, more than 40% of whom report spending all or most of their personal savings on large medical bills.

Dr. Uzzilia noted that in comparison to an emergency room visit, ECA patients see a much lower bill. “I would say the vast majority of those patients never see the inside of a hospital. They pay for just an office visit, reducing the cost of the patient’s care because they never need the inpatient stay, they don’t need the emergency room, they don’t need multiple physicians. Their evaluation and treatment is all in one place with one team.”

Get Answers

Call 518-292-6090 Speak to a cardiac nurse to assess your symptoms and seek treatment

When It’s Your Heart, It Just Can’t Wait

If you are a heart disease patient, have a family history of heart disease, or have engaged in unhealthy activity or lifestyle choices (like smoking cigarettes) you should talk with your doctor about your risk of cardiovascular disease, heart attack, and stroke. Even with a firm understanding of your risk, some of us miss the warning signs of a cardiac event. Uzzilia noted,”there are a lot of things out there that give you an idea of what the symptoms of heart attack might be, but sometimes they don’t follow the textbook.” The classic symptoms of chest pain radiating to the arm with shortness of breath, nausea and sweating. “But everybody is different in how they experience these symptoms,” shared Uzzilia. “Classically women and patients with diabetes will have different symptoms. Sometimes there is no chest pain at all. They may feel fatigue or a profusely sweat. Sometimes they have discomfort in their jaw, back, or arm. We actually say a patient recently who was going for elbow surgery; she was being cleared by her primary care physician when they noticed her EKG didn’t look right. They sent her over to us and it turned out that she was having a heart attack. She needed a stent in one of her coronary arteries. She never needed elbow surgery. Her elbow pain went away — that was her presenting symptom. Very usual but she did have diabetes. Fortunately for her, that primary care physician did a great job of getting her to us quickly and we were able to address her real problem which was her heart.”

How long does a heart attack last and when should you get help? I asked Dr. Uzzilia about the importance of immediate medical attention when you feel the symptoms or on-set of heart attack. If a risk of heart attack can be monitored by your doctor and living a heart health lifestyle, a good diet, and avoiding risks, is it also possible that there is time to treat a heart attack while it happens? “There is time to treat a heart attack,” said Uzzilia. “Time is important though. One of the first things we learn in cardiology is that time is muscle or time is myocardium (muscular middle layer of the wall of the heart). If it turns out that your heart is talking to you and it’s saying there is a problem, then it’s very important to get that evaluate quickly! If you are in fact having a heart attack those symptoms are your body’s way of telling you that the blood supply is not right and it’s critical to get treatment so that we can open up those arteries and prevent muscle cells from dying.”

Same day testing. Dr. Uzzilia and I talked about the slogan of the ECA, “When it’s your heart, you just can’t wait.” Receiving immediate treatment is a life saving, getting information when you are trying to determine if this is a serious life event, to a heart patient this request is equally critical. Uzzilia explained, “one of the most important triage points, especially when we are dealing with a potential heart attack, is the EKG. That test determines what the next steps are going to be. We’re reviewing the EKG immediately upon the patients arrival. We are very fortunate that we have an excellent lab, we can have blood results in as often as 30 minutes. We have access to CT scans that look at the aorta for blood clots. We can look at the coronary arteries. We can do profusion imaging or assessment of blood flow to the heart. We can do an echocardiogram. We have a lot of tools at our disposal. We can not only order those tests, but have them done and interpreted almost immediately.”

Written by: Michael Arce, Marketing Coordinator

Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.

The Mediterranean Diet Plan

Heart Health, Nutrition

The Mediterranean Diet Plan

Make The Lifestyle Change This Summer

JUNE IS NATIONAL MEN’S HEALTH MONTH

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Heart-Healthy Living

The Diet for Heart Patients

Earlier this month during a taping of HeartTalk presented by Capital Cardiology Associates, Dr. James O’Brien mentioned the Mediterranean diet. He said it was a diet that he strongly recommend for patients with heart disease. Now, being a health and fitness enthusiast and a 40-year old man with a family history of diabetes and heart disease, I am always open to ways to improve my heart health.

The Mediterranean Diet

Eating Fresh

Dr. O’Brien proclaimed that the benefits of the Mediterranean diet as a push away from using animals as a protein source, introducing more fruits and vegetables in meals, while also cutting out butter in favor of using oils cooking. It seemed simple which made me skeptical. I know that in dieting nothing good is easy. When I got back to office I started my research and was surprised to learn that the Mediterranean diet was endorsed by the American Heart Association and Mayo Clinic.

And this before that I discovered that you could have a glass or two of wine with dinner on the Mediterranean diet! We’ll get into why wine is good for you a little later in the article.

The following weekend I was looking for a book on this diet at Barnes & Noble in Colonie Center. A title caught my eye, “The Mediterranean Diet Plan,” written by Susan Zogheib. After reading the book’s introduction I quickly skimmed through the background of the diet and stopped at the diet plans. I smiled. I thought to myself, “I could totally do this!” I skipped ahead to the recipes. At that moment I knew I had found my diet plan! The book has four, four-week diet plans complete with recipes for every meal that are structured on the level of comfort you have with making the switch. One month of meals AND recipes, I couldn’t wait!

I read the book while sitting by the pool that Sunday afternoon and informed my girlfriend that we were going to be starting a new diet on Monday. “Oh really,” she asked. “What is so good about this diet?” I told her about the salads, fresh fruit and vegetable dishes, and her favorite part, how we would be replacing steak night with chicken and much more fish. “This is the perfect diet for summer!”

Recently, I had the chance to speak with the author of “The Mediterranean Diet Plan,” Susan Zogheib, a registered dietician about her diet plan. Susan will be joining me for an upcoming episode of HeartTalk presented by Capital Cardiology Associates this month (Sunday, June 24th). I wanted to share the highlights of conversation before YOU grocery shop this week so that you can discover the join of healthy eating this summer.

Discover The Health Benefits

What Makes The Summer The Best Time To Make The Switch

“I think the Paleo, Atkins, there are so many diets out there that really deprive people of the absolute nutrients that they need,” says Zogheib. “The Mediterranean diet has a lot of fruits and vegetables, whole grains, and not necessarily a lot of beef because beef is more fatty, so it incorporates fish and poultry.”

A majority of the meal planning for the Mediterranean diet consists of fresh fruits and vegetables. A sample days meal menu consists of: a pumpkin-gingerbread smoothie for breakfast, Macaroni with Milk (Macoroni oil-Hali) for lunch, and Trout with Wilted Greens for dinner. Your suggested snacks during the day: Mango-Pear Smoothie, cashews and raisins, low-fat ricotta cheese with peaches, hummus, and seed and nut snack bars.

Tell me the last time you ever ate like that.

While reading the weekly meal plans I could close my eyes and picture enjoying the tastes of these dishes while soaking in the awesome summer weather on the patio with my girlfriend, with a glass of my favorite California red wine. “The diet also recommends four ounces of red wine in the evening with your meal. Red wine contains flavonoid which helps reduce your risk of developing cardiovascular disease. That’s my favorite part,” shared Susan.

The wine part, that’s my favorite too.

This is why I recommend that if you are looking to change your diet or just something new this summer, pick up a copy of the book and try a dish. If you do, I’d love to hear which one you made and how it was received!

Why Is This Diet Right For Heart Patients?

How many times have you heard a doctor specifically name a diet that fights heart disease and helps you lose weight? By name? We’re always told to eat healthy, maybe you are given a list of foods to add or avoid but from that point it’s on you to bring the meal plan together. Not with the Mediterranean diet. “This diet is for anyone but specifically for those with high blood pressure,” says Susan. “This is a low sodium, low fat, low cholesterol diet. It’s also ideal for those that are at risk for developing cardiovascular disease. It’s also great for weight loss or management, so if you are looking to shed a few pounds this is a great diet to embrace.”

You start each day with a heart healthy breakfast. Your vegetable intake is increased. You find yourself making trips to the farmers market to get a better variety of fresh fruits and veggies. You stop eating processed food. And that’s a big one. Let’s talk about bread for example. Besides price and taste, what is the difference between white and whole grain bread?

Susan answered, “White bread is so refined that the nutrients are stripped down, again it’s a simple carbohydrate where when a diabetic eats something, there blood sugar will rise and you get a boost of energy. This is the difference between a whole grain and a white-refined bread, once you consume that bread your blood sugar will rise for a little while and you’ll feel energized but the whole grain has better effect on your blood sugar, sustaining that energy over a longer period of time, avoiding the ‘crash and burn’ some feel when eating white bread. Keep in mind that in white bread all of the nutrients have been processed out of the food.” The other difference, you can literally, “Taste the difference when you eat one over the other.”

This diet also works for every type of eater who wants variety in their meals. I don’t know about you, but I’ve never had Pistachio-Crusted Sole much less would I know how to make it. But in the “Mediterranean Diet Plan,” everything I need to know is on page 175 along with substitution tips in case I can’t find pistachios or want to try pecans or cashews instead. I also can see the health breakdown too. “The Mediterranean diet incorporates as lot of nuts, like walnuts, pistachios, and cashews which have a lot of fiber,” adds Zogheib. “Also tuna fish, king mackerel, salmon, all have omega 3 and omega 6 fatty acids. There’s are whole grains, bananas, and one of the best oils to bake with — canola and olive oils. You can replace fatty butter with these oils when baking.”

Putting The Focus Back On Food

In her book, Susan highlights one of the major problems with dinner time today: quality time. Does everyone else remember when dinner time was family time? When we would all sit down together, share our day, talk, laugh, and leave when the meal was done? Susan and I shared our childhood dinning experiences when we discussed her call for embracing the the Mediterranean lifestyle — incorporating exercise, relaxation, and family meals back into our daily routines. This book is looking for someone who is looking to make a lifestyle choice. The way that you eat, sitting down with your families at the dinner table. No more meals on the go, no more meals with the TV. I wanted to bring back the importance of food in our households,” noted Susan.

She recommends eating outdoors, using our lunch hour to incorporate a half-hour walk with a friend, turning off electronics at meals, and stepping outside for walk after meals. I have to tell you, I felt like I was 12 when we put the “no electronics” rule back into play at my home. Dessert used to be my thing after dinner, now it’s taking a walk around the neighborhood with my son or girlfriend.

Meal planning also causes you to look at your calendar and consider everyones schedule. Grocery shopping can again become part of the family routine with everyone contributing to the meal. You’ll also notice a change in your weekly food budget. Susan pointed out that she had, “Given a presentation on the cost of buying food and cooking meals at home saved $1,200 a year versus eating out. Eating out on average costs people about $2,000 a year. Yes, there are some up front costs when buying the spices or equipment you may need but the second time you go to use them, you are saving instead of spending.”

In my food shopping we save about $40 a week even though we eat seafood twice a week. A fillet of salmon or swordfish that feeds two is about the same price of the cut of steak that I would grill for myself. Preparing snacks on Sunday night also means no more trips to the office vending machine for that late-day snack. “I joked around with a couple of colleagues last week in my presentation,” Susan mentioned. “I said, ‘You know, we’re paying for diabetes, we’re paying for high blood pressure. Why not invest your money and diet in food sources that are good for you body?'”

To hear my full conversation with Susan Zogheib listen to HeartTalk presented by Capital Cardiology Associates on Sunday, June 24th at 2PM on NewsRadio WGY or the iHeartRadio app.

Written by: Michael Arce, Host of HeartTalk presented by Capital Cardiology Associates

Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.

Do Smoking And Soda Bans Work?

Heart Disease, Heart Health

Do Smoking and Soda Bans Work?

Focusing On Heart Healthy Legislation

In 2013, New York City Mayor Michael Bloomberg banned “sugary beverages” larger than 16 ounces sold in New York City. Restaurants with self-service soda fountains could not have cups larger than 16 ounces. Convenience stores and supermarkets were excluded. Under the ban restaurants that failed to comply would be fined $200. You may recall the outrage that came with this ban, along with the challenge in the State Supreme Court. Eventually the Court ruled against the ban and Bloomberg spent the remainder of his final year in office proposing a ‘health in all policies’ approach to legislation.

Researchers at Columbia University’s Mailman School of Public Health reviewed health relevant legislation in New York City from 1998 to 2017 and found that 7.4 percent of the 3,745 pieces of legislation introduced during the Bloomberg Administration had the potential to impact New Yorker’s cardiovascular health. The news was published online in the journal Cities and Health.

The team focused on four categories of factors associated with cardiovascular health: air pollution exposure, physical activity, dietary intake, and tobacco smoke exposure — the one most targeted by legislative efforts. Dr. Robert Benton, Director of Clinical Research at Capital Cardiology Associates, took notice of our governments role in public health policies. “In this case, you have government taking a good attitude to try and help you, help yourself. Your government is working to protect you from environmental toxins as well as educate you about what’s in the food you eat,” said Benton.

In 2008, New York City was the first to require that chain resturaunts put calorie information on their menus and drive-thru signs. It became federal law in 2011. For many of us, it was difficult to determine the difference between the price and number of calories. “I think it is scary when you see the amount of calories on menu items,” exclaims Dr. Benton. “It does give people pause to say, “Wow, if I eat that donut it’s going to take me two hours to work that off!” Getting that information to people at the moment they are making a decision, that is really important. Does it mean you can’t have that soda all the time? No. Does it mean you can’t have a sandwich once in a while? No. Knowing those facts is going to help you make better choices in the long term. What I hope as a heart doctor is that instead of eating 10 donuts, you have one. Providing this dietary information helps shape healthy eating habits.”

Do ‘Health In All Policies’ Work?

In the NYC legislation study, researchers found, “the potential of a ‘health in all policies’ approach that a city takes — whether it’s regulatory changes, taxes, or innovative health promotion campaigns — can make a difference,” noted Y. Claire Wang, ScD, MD, Mailman School associate professor of Health Policy and Management. “Our data suggested that the Bloomberg administration and the legislations enacted during that period reduced cardiovascular diseases among New Yorkers; these policy efforts can serve as a model for other municipalities to pursue similar results.”

“There are so many things in our environment and our daily habits that we can act on ourselves.”

Dr. Robert Benton

Director of Clinical Research, Capital Cardiology Associates

America’s Fittest Cities

One key win for public health was a decline of smokers in New York City. New tax laws on cigarettes sold in NYC and the Smoke-Free Air Act reduced smokers from 35% to 14%, since 2002. When examining the success of public health policies it’s important to look at the numbers. According to the American College of Sports Medicine (ACSM) 2018 American Fitness Index Rankings, over 8.5 million people live in New York City. Of that, almost 28% have high blood pressure, 3.5% have angina or coronary heart disease, and 2.4% have stroke. These numbers recently ranked New York City as the 52nd fittest city in America. Buffalo was the only other city in the state to make the list with ranking of 43. Comparing the data between Buffalo and New York City, NYC residents enjoy a better personal and community health ranking.

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“There is an interest in your government, believe it or not, in having you live a healthy lifestyle,” declared Dr. Benton. “The costs of health care are huge in this country. We could save so much if people ate a healthy diet and exercised. Why not let people know that? Why not remind people of that? Not to the point of being onerous but allowing you to make your own decisions, giving you the information to be confident with your lifestyle choices.”

Columbia University researchers agree. While this was one of the first studies to examine the impact of public health policies on the population, further research will be needed to evaluate the long-term impact legislation has on health. The report concluded that, “Future research on how these policies impact segments of the population — the young, older adults, and people residing in socio-economically depressed neighborhoods — are the missing pieces and will be equally important for informing legislative efforts.”

Written by: Michael Arce, Media Specialist

Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.